Active NPI
Tracy Ann Thomas, PH.D.
- Clinical Psychologist
- Storm Lake, IA
National Provider Identifier
1699189100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1242
- Practice address
- 712 Emerald Dr
Storm Lake, IA 50588-2719 - Phone
- (712) 730-8274
- Fax
- (712) 248-8655
- NPI assigned
- Jun 12, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1242 | IA | Primary |
Addresses
Primary practice location
712 Emerald Dr
Storm Lake, IA 50588-2719
Mailing address
712 Emerald Dr
Storm Lake, IA 50588-2719
Phone (712) 730-8274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1242 | IA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406505600000",
"number": "1699189100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 EMERALD DR",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505882719",
"telephone_number": "712-730-8274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 EMERALD DR",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505882719",
"telephone_number": "712-730-8274",
"fax_number": "712-248-8655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "TRACY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-12",
"last_updated": "2014-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IA",
"license": "1242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Storm Lake, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.